Basic Information
| Provider Information | |||||||||
| NPI: | 1588645626 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | STEVEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2931 DOCTORS PARK DR | ||||||||
| Address2: | |||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975048127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412454444 | ||||||||
| FaxNumber: | 5412454443 | ||||||||
| Practice Location | |||||||||
| Address1: | 691 MURPHY RD | ||||||||
| Address2: | SUITE 128 | ||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975044346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412454444 | ||||||||
| FaxNumber: | 5412454443 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2005 | ||||||||
| LastUpdateDate: | 12/21/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 713544 | OR | Y | Chiropractic Providers | Chiropractor |
ID Information
| ID | Type | State | Issuer | Description | 856434001 | 01 | OR | BLUE CROSS BLUE SHIELD | OTHER | P00211392 | 01 | OR | PALLMETTO MEDICARE | OTHER | 61218220 | 01 | OR | SAIF | OTHER | 5589753 | 01 | OR | FIRST HEALTH | OTHER | 023096 | 05 | OR | MEDICAID | 612182200 | 01 | OR | US DEPT OF LABOR | OTHER |